England prop Phil Vickery will miss the entire Six Nations championship after being told he needs surgery to repair a long-standing back injury. Vickery suffered a recurrence of the injury earlier this month and withdrew from the squad to face Wales.
The 29-year-old, who has 47 caps, will have the operation on Saturday and is unlikely to play again this season.
The operation, the third on his back, is designed to relieve pressure on a nerve root caused by a disc protrusion.
"In view of the fact he has had previous surgery in this area, his recovery and rehabilitation will be carefully monitored by his specialist and the Gloucester and England medical teams," said Gloucester head coach Dean Ryan.
"He faces three months' rehabilitation from the operation, and there is obviously a great likelihood it will disrupt the rest of his season. "But we remain very positive that his outlook is bright."
Vickery, who was part of England's 2003 World Cup-winning side, has previously said he feared for his long-term future in the sport because of the number of back injuries he had suffered.
He has had back operations in February 2003 and May 2004, as well as a shoulder operation in the summer of 2000.
Vickery started England's games with Australia and New Zealand last November and was expected to play an important part in this year's Six Nations.
England head coach Andy Robinson said: "Our best wishes will be with Phil on Saturday.
"It shows what a fighter he is that he has twice come back from surgery and we are hoping that this operation is also successful.
"He is an outstanding member of the England squad and will be sorely missed by us and Gloucester."
Trevor Woodman, who played on the other side of England's scrum in the World Cup final, retired last year because of a back injury.
Woodman said he had the utmost sympathy for Vickery's present plight.
"I know exactly what he's going through," Woodman said.
"The unknown is more scary than anything else. I really feel for him and I know from my own experience that support is vital."
Vickery missed last year's Lions tour after failing to recover from a broken arm.
In addition to his previous back surgery, Vickery has also suffered a fractured eye-socket.